Original ArticlesOxidative stress in asphyxiated term infants resuscitated with 100% oxygen☆,☆☆
Section snippets
Design
This is a randomized clinical trial, blinded for the gas source during resuscitation. Randomization was performed by assigning a sealed enveloped containing a computer generated random number plus a statement indicating the corresponding group (100% oxygen or room air) to each mother's record at admission to the obstetric ward before delivery. Eligible patients were recruited among term neonates (37-40 weeks' gestation) born at the Hospital Virgen del Consuelo that showed evident signs of
Results
There was an increased rate of cesarean delivery among the asphyxiated infants (72%) compared with the control group (32%) (Table I). In addition, significant differences because of the presence of fetal bradycardia, meconium-stained amniotic fluid, and the need for intubation occurred in the asphyxiated neonates compared with the control group.
The median Apgar score at 1 and 5 minutes was significantly lower in the asphyxiated newly born infants than in the control nonasphyxiated group (Table
Discussion
Oxidative stress is a physiologic event in the fetal-to-neonatal transition. In isolated hepatocytes from fetal and newborn rats, we found a dramatic decrease (15- to 20-fold) in the GSH/GSSG ratio, mainly because of a marked increase in the GSSG concentration in the fetal-to-neonatal transition.3 In addition, all the enzyme activities involved in the glutathione redox cycle increased during that transition, especially glutathione peroxidase and glutathione-s-transferase.3 Similar results were
Acknowledgements
We thank Marilyn R. Noyes for revising the manuscript.
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Supported in part by the Annual Research Grant (1999) of the Sociedad Española de Neonatologia (to M. V.).
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Reprint requests: Máximo Vento, PhD, MD, Servicio de Pediatría, Hospital Virgen del Consuelo, Callosa de Ensarriá, 15 bajo, E-46007 Valencia, Spain. E-mail: [email protected]